Glaucoma Adherence—From Theriac to the Future

Since the beginning of medical care, physicians have recognized the difficulty with medication adherence. Gupta and associates found that more than 90% of glaucoma patients instill their eye drops incorrectly; 30% of patients missed the eye, and 75% of patients contaminated the bottle against the ocular or periocular surface.10 In a study using video recordings, 60% of patients reported never missing an eye drop, but less than 30% successfully instilled an eye drop on video review.11 Like the Kass article referenced above, patients routinely overestimate their ability to administer eye drops. The Kali Drop device (Kali Care, Mountain View, California) attaches to the body of an eye drop bottle and uses a combination of motion and tactile sensors to track eye drop usage.12 The authors have developed the Devers Drop Device (Universal Adherence, Portland, Oregon), which is a reusable silicone monitor and alert system that couples to any eye drop bottle cap while permitting normal functioning of the bottle cap.